Relationships between functional fitness and cognitive impairment in Chinese community-dwelling older adults: a cross-sectional study

The relationship and pathways between resting-state EEG, physical function, and cognitive function in older adults

OBJECTIVE

Based on resting-state electroencephalography (EEG) evidence, this study aimed to explore the relationship and pathways between EEG-mediated physical function and cognitive function in older adults with cognitive impairment.

METHODS

A total of 140 older adults with cognitive impairment were recruited, and data on their physical function, cognitive function, and EEG were collected. Pearson correlation analysis, one-way analysis of variance, linear regression analysis, and structural equation modeling analysis were conducted to explore the relationships and pathways among variables.

RESULTS

FP1 theta (effect size = 0.136, 95% CI: 0.025-0.251) and T4 alpha2 (effect size = 0.140, 95% CI: 0.057-0.249) were found to significantly mediate the relationship. The direct effect (effect size = 0.866, 95% CI: 0.574-1.158) and total effect (effect size = 1.142, 95% CI: 0.848-1.435) of SPPB on MoCA were both significant.

CONCLUSION

Higher physical function scores in older adults with cognitive impairment were associated with higher cognitive function scores. Left frontal theta and right temporal alpha2, as key observed indicators, may mediate the relationship between physical function and cognitive function. It is suggested to implement personalized exercise interventions based on the specific physical function of older adults, which may delay the occurrence and progression of cognitive impairment in older adults with cognitive impairment.

Exploring the Associations between Functional Capacity, Cognitive Function and Well-Being in Older Adults

Background: The present study aimed to explore the associations between functional capacity and global cognition, executive function and well-being in older adults. Methods: Ninety-seven older adults (age 80.6 ± 8.2 years) were examined for global cognitive function (Mini-Mental State Examination), executive function (symbol cancellation test), functional capacity (sit-to-stand tests, 6 min walk test, timed up-and-go test and handgrip strength test) and well-being (quality of life, fatigue levels, sleep quality and daily sleepiness). Adjusted partial correlations were computed to examine the associations between variables. Mediation analyses were conducted to evaluate whether functional capacity would mediate the relationships between age and cognitive or executive function. Results: Greater levels of functional capacity were associated with better performance in cognitive and executive function tests (p < 0.05). Mediation analyses revealed that functional capacity partially mediated the effects of age on global cognition and executive function (indirect effect: β = −0.11, 95% CI = −0.20 to −0.03; β = 0.34, 95% CI = 0.13 to 0.57, respectively). Increased levels of functional capacity were also associated with higher quality of life (p < 0.05, r = 0.32 to 0.41), lower fatigue levels (p < 0.05, r = 0.23 to 0.37), and better sleep quality (p < 0.05, r = 0.23 to 0.24). Conclusions: Functional capacity can mediate the effects of age on global cognition and executive function in older adults and greater levels of functional capacity are associated with improved quality of life, better sleep quality, and lower fatigue levels.

Prevalence of Disability among the Chinese Older Population: A Systematic Review and Meta-Analysis

BACKGROUND

Disability is an important problem in aging societies globally. However, the research findings of the prevalence of disability have been inconsistent. This study aims to estimate the prevalence of disability and its influencing factors among the Chinese older population from 1979 to 31 July 2021.

METHODS

A systematic review and meta-analysis were conducted using both international (PubMed, Web of Science, CBMdisc, PsycINFO, the Cochrane Library, and EMBASE) and Chinese (CNKI, CQVIP, and WanFang) databases. Meta-analysis was performed using a random-effects model to account for heterogeneity. Subgroup analyses were also done.

RESULTS

The pooled prevalence of disability across all 97 studies was 26.2% (95% CI: 23.7-28.6%). The estimates varied according to the types of activities of daily living (ADL), gender, age, and region. Studies based on the identification of cases by using the complete ADL scale showed a higher prevalence than those using the basic ADL scale. The prevalence was slightly higher among female older individuals than among male older individuals. The highest rates were seen in older individuals aged 80 years or older. Elders in central China, southwest China, and northwest China were more likely to be BADL-disabled.

CONCLUSION

Prevalence of disability among the Chinese older population is high, around 26%. Using standardized diagnostic systems to correctly estimate the prevalence of disability would be helpful for public health professionals in China.

Relationship Between Aerobic Capacity, Mobility, and Spatial Navigation in Healthy Individuals and Older Adults With Mild Cognitive Impairment: A Cross-Sectional Study

This study aimed to investigate the relationship between physical ability and spatial navigation in older adults with mild cognitive impairment and healthy controls, using the floor maze test. Study participants (n = 58) were subjected to the following tests: floor maze test, sit-to-stand, 8-foot up-and-go, and aerobic steps. Factorial analyses showed that performance of the physical tests combined explained approximately 87% of the sample variability. Mobility (R2 = .22, p ≤ .001) and aerobic capacity (R2 = .27, p ≤ .001) were both associated with delayed maze time in the floor maze test. Low levels of aerobic capacity were also associated with an increased odds to perform poorly in the delayed maze time after controlling for age, sex, and mild cognitive impairment diagnosis (odds ratio = 3.1; 95% confidence interval [1.0, 9.5]; p = .04). Aerobic capacity and mobility are associated with spatial navigation in patients with mild cognitive impairment and healthy older adults.

Effectiveness of Facebook Remote Live-Streaming-Guided Exercise for Improving the Functional Fitness of Community-Dwelling Older Adults

Background: The aim of this study was to determine the effect of Facebook remote live-streaming-guided exercise on the functional fitness of community-dwelling older adults. Method: This study used a non-randomized controlled design with single-blinding (outcome assessors). Older adults (mean age = 70.36 ± 4.51 years) were assigned to either the experimental group (n = 39) or the control group (n = 34). The experimental group participated in a 75-min Facebook remote live-streaming-guided exercise routine twice a week for 8 weeks at home, whereas the control group maintained their original lifestyle without any intervention. Functional fitness was assessed using the Senior Fitness Test, which assessed upper and lower limb flexibility and muscle strength, cardiorespiratory fitness, and balance. The test was administered before and after the intervention. Results: The results revealed that an 8-week Facebook remote live-streaming-guided exercise intervention increased lower limb flexibility and muscle strength and cardiorespiratory fitness in community-dwelling older adults. Conclusion: The current findings suggest that a home-based exercise program using the Facebook platform may be a feasible method to broadly improve the functional fitness of community-dwelling older adults.

Is functional fitness performance a useful predictor of risk of falls among community-dwelling older adults?

Background

Falls among older adults are a serious public health problem. Many studies indicate that positive functional fitness performance decreases the risk of falls. A limited amount of previous study has investigated the association between broad functional fitness and the fall risk. This study examines the associations between functional fitness and the risk of falling among community-dwelling older adults.

Methods

Three waves of cross-sectional data were collected from 2017 to 2019 in Taipei City, Taiwan. Six hundred sixty-five participants aged ≥65 years were randomly recruited from 12 districts of Taipei. Eight functional fitness tests (i.e., back scratch, chair-sit and-reach, 8-ft up-and-go, 30-s sit-to-stand, 30-s arm curl, 30-s single-leg stance, 2-min step, and hand grip strength tests) were performed to record the physical performance of older subjects. A Chinese version of the fall-risk questionnaire (FRQ) was used to calculate the fall risk scores. Linear regression and logistic regression were utilized to estimate the relationships of each functional fitness and fall risk.

Result

The results showed that 37.45% of older adults had a high risk of falling. It was found for each functional fitness that performance was linearly associated with the risk of falling. Moreover, older adults with low-performance levels in all functional fitness except back-scratching were more likely to have a higher risk of falling.

Conclusions

Our study indicated that functional fitness performance appears to provide valid predictive guidance for reducing the risk of falling among the older population.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-021-00608-1.

Healthy Lifestyle and Cognition: Interaction between Diet and Physical Activity

PURPOSE OF REVIEW

This review discusses current research on the impact of specific dietary patterns and exercise, both individually and combined, on cognitive function in older adults.

RECENT FINDINGS

Observational evidence generally supports a relationship between diet adherence and positive cognitive outcomes related to memory, executive function, and risk for cognitive impairment; however, randomized controlled trials (RCTs) are limited. Exercise research is more extensive, showing improvements in cognitive performance after exercise interventions regardless of baseline cognitive status and noting lower incidences of cognitive impairment in people who engage in regular physical activity. Evidence supports adherence to specific dietary patterns and a combination of aerobic and resistance exercise as an effective approach to mitigate age-associated cognitive decline. Further research on older adults at various stages of cognitive decline, as well as longer-term RCTs, will help determine the best clinical markers of early cognitive dysfunction, and the effectiveness of early lifestyle intervention on cognitive function.

Test-retest reliability of the functional reach test and the hand grip strength test in older adults using nursing home services

OBJECTIVE

This study aimed to determine the absolute and relative test-retest reliability of the functional reach test (FRT) and the handgrip strength test (HGST) in older adults using nursing homes.

METHODS

Participants (≥ 65 years old), living in nursing homes or using their day care services, were distributed into a group without cognitive impairment (GWCI, n = 43) and a group with mild cognitive impairment (GCI; n = 22). A 1-week test-retest was performed for the FRT and the HGST. Relative reliability was measured by the intraclass correlation coefficient (ICC_3.1), and absolute reliability by the standard error of measurement (SEM), minimal detectable change (MDC₉₅), and Bland-Altman plots.

RESULTS

The ICC showed high reliability for the FRT (GWCI, ICC = 0.83; GCI, ICC = 0.87) and the HGST (ICC ≥ 0.95 in both hands and participant groups). The absolute reliability was good: FRT, SEM = 2.96/2.29, MDC₉₅ = 8.20/6.35 for the GWCI and the GCI, respectively; HGST dominant hand SEM = 1.26/0.82, MDC₉₅ = 3.50/2.29, and HGST non-dominant hand SEM = 1.05/0.80, MDC₉₅ = 2.90/2.21, for the GWCI and the GCI, respectively. Bland-Altman showed that there was not a systematic bias for the tests in both groups.

DISCUSSION

Findings show that the FRT and the HGST are reliable, have acceptable measurement error, and may be used for research and clinical purposes to assess functional balance and strength of the hands in older adults using nursing homes.

Domestic Activities Associated With a Decreased Risk of Cognitive Disorders: Results of the "Fréle" Cohort

Background: Previous cohorts studied the association of various types of physical activities with the incidence of cognitive disorders. The objective of this work was to analyze the association of leisure, domestic and professional physical activities with mild and moderate cognitive disorders in older people living in the community. Methods: We used retrospective data from the "FRéLE" (FRagilité: étude Longitudinale de ses Expressions) a longitudinal and observational study. Data collected included socio-demographic variables, lifestyle and health status. Cognitive disorders were assessed using the Montreal Cognitive Assessment (MoCA). Two cut-offs of MoCA were used to analyze mild and moderate cognitive disorders. Physical activity was assessed by the Physical Activity Scale for the Elderly (PASE) structured in three sections: leisure, household, and professional activities. Spline and logistic regression models were used to estimate the risk of cognitive disorders. Results: At baseline, 428 participants (for study of mild disorders) and 1,271 participants (for study of moderate disorders) without cognitive disorders were included in the analysis. The mean ages were 74 and 78 years, respectively. After a 2-year follow-up, we found mild cognitive disorders in 154 participants (36%) and 71 cases of moderate cognitive disorders (5.6%). In multi-adjusted logistic models, domestic activities were associated with cognitive disorders, but not leisure and professional activities. Conclusion: We found an inverse relation between domestic sub-score and cognitive disorders defined by MoCA < 18. With a specific questionnaire and quantitative information on the type of activities, this study contributed to the debate on the beneficial effects of physical activity on cognition.

Effects of Progressive Resistance Training on Cognition and IGF-1 Levels in Elder Women Who Live in Areas with High Air Pollution

The aim of this study was to determine the effects of a muscular strength programme on the levels of insulin-like growth factor-1 (IGF-1) and cognitive status in elder women with mild cognitive impairment who lived in areas of high air pollution. A total of 157 women participated in the study, distributed in four groups: Active/Clean (AC n = 38) and Active/Pollution (AP n = 37), who carried out a progressive resistance training programme for 24 months, and Sedentary/Clean (SC n = 40) and Sedentary/Pollution (SP n = 42). Maximum strength in the upper and lower limbs (1RM), cognition (Mini-Mental Scale Examination (MMSE)) and blood IGF-1 were evaluated. At the beginning of the intervention, there were no differences between the groups in the assessed variables. The active groups which carried out the resistance training programme (AC and AP), registered better results in IGF-1 than the sedentary groups. These differences were statistically significant in AC vs. SC (p < 0.01) and AP vs. SC (p < 0.05). Regarding MMSE, group AC registered the highest score increases (+8.2%) (significantly better than the other groups), while group SP worsened (−7%) significantly compared to the other three groups. In conclusion, resistance training had a positive effect on IGF-1, while sedentary behaviour and air pollution had a negative effect on cognitive status.

Temporal Patterns in Performance of the 30 Second Chair-Stand Test Evince Differences in Physical and Mental Characteristics Among Community-Dwelling Older Adults in Japan

Studies involving the 30 s chair-stand test (CS-30) have shown that subjects’ movements can vary during the test, and that these variations may follow several patterns. The present study aimed to define these different patterns and their respective incidences among a population of community-dwelling older adults in Japan. We also investigated, among the patterns identified, potential associations with physical and mental characteristics. The study population comprised 202 community-dwelling older adults. Subjects were classified into four groups based on how their CS-30 performance (defined through sit–stand–sit cycle count) changed over three successive 10 s segments: “steady-goers,” “fluctuators,” “decelerators,” and “accelerators.” Several other measures were also evaluated, including sit-up count, knee-extension strength, toe-grip strength, and Mini-Mental State Examination score. We found that steady-goers and decelerators comprised 70% of the sample. Fluctuators and steady-goers showed comparable physical function. Decelerators exhibited significant correlations between CS-30 score (total cycles) and tasks involving persistence and repetitive actions (p < 0.05). In addition, accelerators showed significantly stronger knee extension than steady-goers (p < 0.01). Differences in temporal patterns of CS-30 performance corresponded to differences in certain dimensions of physical and mental function. Our findings may be useful for planning and evaluating intervention programs aimed at long-term-care prevention among community-dwelling older adults.